Individual provider Active NPI

Cristina Q. Flake, LCSW

  • Mental Health Counselor
  • Durham, NC
National Provider Identifier
1750448395
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCSW NO. 002980 Issued in NC
Practice address
433 W Main St
Durham, NC 27701-3217
Phone
(919) 433-0170
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCSW NO. 002980 NC Primary

Addresses

Primary practice location

433 W Main St
Durham, NC 27701-3217

Mailing address

235 Woodhaven Rd
Chapel Hill, NC 27514-7510
Phone (919) 929-6794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW NO. 002980NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Easter Seals Ucp North Carolina & Virginia, Inc. Mental Health Past Accepting new patients
Easter Seals Ucp North Carolina & Virginia, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750448395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 WOODHAVEN RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275147510",
            "telephone_number": "919-929-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 W MAIN ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013217",
            "telephone_number": "919-433-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAKE",
        "first_name": "CRISTINA",
        "middle_name": "Q.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "LCSW NO. 002980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.